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Meeting rural demand: a case for combining community-based distribution and social marketing of injectable contraceptives in Tigray, Ethiopia
- Source :
- PloS one, vol 8, iss 7, PLoS ONE, PLoS ONE, Vol 8, Iss 7, p e68794 (2013)
- Publication Year :
- 2013
- Publisher :
- eScholarship, University of California, 2013.
-
Abstract
- BACKGROUND: In Sub-Saharan Africa, policy changes have begun to pave the way for community distribution of injectable contraceptives but sustaining such efforts remains challenging. Combining social marketing with community-based distribution provides an opportunity to recover some program costs and compensate workers with proceeds from contraceptive sales. This paper proposes a model for increasing access to injectable contraceptives in rural settings by using community-based distributers as social marketing agents and incorporating financing systems to improve sustainability. METHODS: This intervention was implemented in three districts of the Central Zone of Tigray, Ethiopia and program data has been collected from November 2011 through October 2012. A total of 137 Community Based Reproductive Health Agents (CBRHAs) were trained to provide injectable contraceptives and were provided with a loan of 25 injectable contraceptives from a drug revolving fund, created with project funds. The price of a single dose credited to a CBRHA was 3 birr ($0.17) and they provide injections to women for 5 birr ($0.29), determined with willingness-to-pay data. Social marketing was used to create awareness and generate demand. Both quantitative and qualitative methods were used to examine important feasibility aspects of the intervention. RESULTS: Forty-four percent of CBRHAs were providing family planning methods at the time of the training and 96% believed providing injectable contraceptives would improve their services. By October 2012, 137 CBRHAs had successfully completed training and provided 2541 injections. Of total injections, 47% were provided to new users of injectable contraceptives. Approximately 31% of injections were given for free to the poorest women, including adolescents. CONCLUSIONS: Insights gained from the first year of implementation of the model provide a framework for further expansion in Tigray, Ethiopia. Our experience highlights how program planners can tailor interventions to match family planning preferences and create more sustainable contraceptive service provision with greater impact.
- Subjects :
- Program evaluation
Rural Population
Non-Clinical Medicine
Epidemiology
Economics
Psychological intervention
lcsh:Medicine
Social and Behavioral Sciences
Sociology
Pregnancy
Residence Characteristics
Medical Sociology
Medicine
Marketing
lcsh:Science
Reproductive health
education.field_of_study
Human Capital
Multidisciplinary
Reproduction
Obstetrics and Gynecology
Middle Aged
Social marketing
Drug Marketing
Socioeconomic Aspects of Health
Contraception
Social Networks
Family planning
Social Systems
Female
Health Services Research
Public Health
Behavioral and Social Aspects of Health
Social Welfare
Research Article
Adult
Drugs and Devices
Operations Research
Drug Research and Development
Adolescent
General Science & Technology
Revolving fund
Cognitive Neuroscience
Population
Decision Making
Injections
Young Adult
Health Economics
Contraceptive Agents
Humans
education
Biology
Demography
Health Services Needs and Demand
business.industry
Prevention
Contraception/Reproduction
lcsh:R
Economics of Health
Social Epidemiology
Good Health and Well Being
Social Marketing
Women's Health
lcsh:Q
Ethiopia
Rural area
business
Neuroscience
Subjects
Details
- Database :
- OpenAIRE
- Journal :
- PloS one, vol 8, iss 7, PLoS ONE, PLoS ONE, Vol 8, Iss 7, p e68794 (2013)
- Accession number :
- edsair.doi.dedup.....d6b4643f194f248cc66d3c20dd555565